Since fellow PT blogger Dr. Steven Stosny and I both share similar concerns with the increasing problem of pathological anger or rage in our culture, I want to comment on a recent posting of his, in which Dr. Stosny broadly depicts anger problems as "a smokescreen for fear-shame phobia."

The problem of anger and rage is of vital importance not only in our daily emotional life, but in the genesis of most mental disorders, violence, spiritual development, and creativity. Anger is inaccurately considered by some psychotherapists to be a secondary rather than primary emotion. Of course, there is some truth to this: Anger, like anxiety, is a reaction to something threatening to the physical and/or psychological, spiritual or existential integrity of the individual. But anger is not a passive helplessness or hopelessness in the face of such a threat. It is not flight, but fight. It is an assertion of the individual's most basic right to being an individual. As in other species, without this capacity for anger or even rage, we would be unable to defend ourselves or those we love when needed. To fight for freedom and what we truly believe in and value. We would be unable to face down evil, leaving us even more vulnerable to it. So, in this sense, while anger--like any other emotion such as sadness, grief, fear, joy, disgust, anxiety or shame--is almost always secondary to some internal or external stimulus.

Certainly, much anger and resentment stems from an underlying matrix of neurotic narcissism and sense of entitlement, as Stosny suggests. Frustration, resentment and anger are also generated by what Guatama Buddha called desire or attachment, which is the expectation that life will work out as we wish. Dr. Albert Ellis' Rational Emotive Behavior Therapy (REBT) similarly recognized the frustrating nature of irrational cognitions like "life should be fair." And anger can be and is used by some (not unlike a drug) to cover up painful feelings, fear, anxiety, vulnerability and shame. John Bradshaw referred to such individuals as "rageaholics." The best defense is a good offense. But I submit that to reduce anger or rage in general to the role of "smokescreen" for fear or shame can be problematical, especially from the pragmatic perspective of psychotherapy. I would argue that anger and rage--along with fear, eros, joy, disgust, surprise and sadness --is, as most developmental psychologists agree, a psychobiologically primary human emotion. And that shame is fundamentally a secondary phenomenon, as illustrated, for example, in the case of both Adam and Eve in Eden.

Anger is perhaps the most troublesome and challenging emotion to tackle therapeutically. Since most therapists today see anger or rage as symptoms of underlying fear, hurt or shame, there is a tendency to de-emphasize the importance and primacy of anger in favor of focusing on that which secondarily fuels it. This is a serious therapeutic mistake in my opinion. A monumental and costly failure of contemporary psychotherapy. For those interested, I have written about this difficult conundrum in considerable detail in my bookAnger, Madness, and the Daimonic: The Psychological Genesis of Violence, Evil, and Creativity.

In my view, it is a grave error to dismiss anger or rage as secondary and therefore less significant emotions than fear, shame, anxiety or love in the psychotherapy process. Anger is a primary emotion that tends to be repressed in most patients. Indeed, it is an emotion, like the experience of anxiety, about which we often feel shame, due to our negative views of anger. Paradoxically, chronic repression of anger creates resentment, bitterness, hostility, hatred and, in some, an overpowering, irresistable rage. For many, to feel angry is to feel out of control, irrational, unenlightened, uncivilized, and this frequently leads to fear, shame and anxiety. And more repression. So which came first in this vicious cycle, the chicken or the egg?

Most patients who seek psychotherapy suffer far more from "anger phobia" than "shame phobia." Indeed, for most patients, it is easier and seems more acceptable and less threatening to allow themselves to feel shame than anger or rage. In this respect, shame, fear or anxiety can mask anger or rage. Unfortunately, mental health professionals also suffer from anger phobia. Like the patients whom they attempt to help, most therapists are consciously or unconsciously fearful of anger or rage, the daimonic. This is in part a pervasive form of what we clinicians refer to as countertransference. Of course, the daimonic is potentially dangerous and destructive, and naturally evokes some fear. The problem is that patients are themselves already quite fearful of their or own anger, and what might happen if they were to allow themselves to fully feel and express it. If the psychotherapist is also too afraid, he or she colludes with the patient to continue avoiding anger, denying its existential power, relevance and value, focusing instead on fear, pain or shame.

In psychotherapy, the single most powerful and healing intervention the clinician can offer is to listen to the angry patient, and to acknowledge and accept his or her rage. Anger and rage have to first be validated, expressed and understood before the underlying affects or cognitions can be effectively addressed. The dilemma is that most mental health professionals denigrate and demonize anger, dismissing it as an inappropriate, destructive and negative and neurotic emotion. But anger is an appropriate, natural and healthy response to frustration, injury, insult, and anything that threatens one's survival or psychological integrity. We need to be able to get angry at such obstacles, challenges and assaults. Anger can bestow strength and tenacity in the face of adversity. When we are socialized to view getting angry as negative, evil, immoral or unspiritual, as so many of us have been, we repress our anger--as we repress other impulses or passions of which we are ashamed. This is exactly what Jung describes as the shadow: those aspects of experience we find unacceptable, reject, and quarantine to unconsciousness. Anger is commonly experienced (if it is consciously experienced at all) as a shameful emotion which must be hidden from others, and often, even from ourselves. The last thing therapists should do when working with angry patients is to further shame them for feeling angry.

Bad behavior when angry is another matter, and must be confronted. Evil deeds and destructiveness toward self or others cannot be condoned. These are neurotic forms of acting out, and function as a defense mechanism against fully experiencing that which underlies the anger or toward whom the anger is truly directed. Still, it is through acknowledging, confronting, articulating and accepting the anger that the patient can become more conscious of what lies behind it, what drives and triggers it. A good deal of my own therapeutic work with patients is dedicated to just that task. Anger is not something that can be avoided or circumvented during the psychotherapy process. Anger is the alchemical key to the healing process, the exclusion or minimization of which impedes rather than promotes therapeutic progress. Without a courageous willingness to deal directly with the daimonic emotions of anger or rage in treatment-- rather than trying merely to manage or defuse them cognitively, behaviorally or pharmacologically--psychotherapists cannot facilitate the deep emotional healing patients seek, and unwittingly contribute to the growing epidemic of anger, rage and violence.

i do agree with you that fear and shame aren't always the causes for anger but i think its important to learn how to isolate anger that stems from them and anger that stems from wanting to protect rights and loved ones. while the first should be dealt with the second is healthy and should be kept

I quite agree that anger is not only highly condemned in the family home, but in therapy, too.

I have seen various therapists in my time, and apart from one, the role seemed to be to convince me that my anxiety/depression were a certain thing and not that big a deal. It has been in my own reflection and learning that I have come to see the enormity of my anger (although i certainly don't appear to be an "angry" person).

Therapists may have various justifications for not dealing in anger. I think there is much to be feared for therapists in a world of lawsuits, so avoiding the whole anger angle is probably a wise move professionally, but it does little to help patients,

I agree that anger is a primary emotion, mostly because some people live their lives in anger, but saying that it's an important part of human life? Maybe for a grizzly bear protecting her cubs, but life in the 21st century makes anger unproductive. You say anger can stimulate change, but really it can't. I and millions of others were angry at Bush for eight years, and although we got change, if it hadn't been for the economic collapse we would've gotten more of the same. All that anger would've only contributed to heart conditions. F*** anger! Rarr!

You are using a false correlation between anger and change. You can get angry all you want at something like the president without getting any change. What he was saying, is that in order to change something in yourself (the key here) you oftentimes have to get angry.

If I want to lose weight and become healthier, getting angry at myself for not starting exercise or for going to Taco Bell may be the only way for me to instigate the change I desire.

Getting angry at my boss for playing favorites won't facilitate change, but will be unhealthy for me. In order to get over the anger towards my boss, my therapist and I would first have to discuss the reality of the anger and acknowledge that it may be justified, but counter-productive to what I am trying to accomplish. (I will never be a favorite if I continue to be angry with him.)

Dr. Stosny has laid out his case very well and is waiting for Dr. Diamonds response still on 1-22-09 7 AM. It is quite interesting to see two learned men explain their ideas on anger to each other. I wish this would happen more often.

Yes I'm the one looking for further discussion. My guess is that Dr. Stosny would welcome it but I don't know for sure. It would be nice if these psychology today blogs would notify you like facebook but they don't. I did check Dr. Stosny's blog and it looks like you will respond when you get some time. Thanks for checking and seeing his latest response to you. Also thanks for being willing to continue a discussion with Dr. Stosny on this vital topic.

Hooray for Stephen Diamond!
The internet is full of anger towards the angry. Blogs and writers seek to punish those who punish others, and blame those who blame others. There appears to be no end to it.
Blogs are becoming a great outlet for displaced anger. If people can’t stand up to the rude boss or the nagging or alcoholic spouse, they create a blog and complain about the people (especially George Bush) who have ruined the planet!
The sense of entitlement now appears to be that anyone is free to attack anyone else.

Nice article. But it is important we know how to handle our anger. We must acknowledge that some anger is a valid, necessary, appropriate and unavoidable human emotion. It is not a question of whether we experience anger as much as how we deal with it.

Maybe anger's association with violence is creating the fear for many.
I have often felt neanderthal-like in my relationship with anger. But I am a simple guy who believes of the truth in nature. Believing that our culture dismisses many important truths in life.
Thank you for your article. Thank you for caring.

The discussion should be about- when it anger justified,and how angry are we talking.

All episodic/psychotic people are angry. All will give you reasons as well.

Anger from Depressives/Bipolar's is due to hyper-sensitivity and mental dysfunction caused by physical differences in the body ( no shut off switch on the adrenal glands) along with brain damage and shrinkage.

I have a psychologist that believes many fear their own anger (anxiety) and our most intense anger is repressed. If the unloved child is not loved where does that anger/rage go? Repressed anger has a lid on it called depression. Infantile depression does exist. It is carried on into adult life and perhaps for life. Treatment obviously is to get that anger/rage out. There is no fear of it after it is vented. Therefore, no depression. Yes, I agree with most of what has been written by Mr Daimond. I am also aware of the opposition to this therapy, because it certainly CAN stir up a therapists own emotions. There will be much debate over these concepts and beliefs in the future because it is THAT SIMPLE.

I wish I had read this years ago. I Love someone "T" who expresses his Fear, or use to express his fear by raising his voice, shouting, shaking, getting right in my face screaming, that I was being unfaithful to him. I never was unfaithful to him.

This started with him getting upset when a tax man would call. I definitely told the man I was only interested in getting my taxes filed. I even told taxman not to call me again and that he was being disrespectful by using my number. I finally put taxman on the right page.

He called me disrespectful when I was speaking to my ex-husband on the phone at his house. I forget who called. It would have been me returning his call or my ex calling me.

I remember "T' getting mad at me at work for just smiling and walking by him and one of his co-workers. I should have stopped and hugged or kissed him. I give him that one.

I remember "T" getting upset sending me text messages like "LIAR, LIAR, LIAR
This was all because someone told him people I dated before him. I had told him I dated a couple of men who had children at the school. These were eligible men who could date. We were not sneaking behind anyones back. I think I even told him who. I convinced him I was not a horrible person but was hurt by things he said. He visited a pastor to speak with him before he really thought that incident was fine.

One very important thing is that I KNEW HE HAD SEEN HIS WIFE AND BEST FRIEND MEET AT A HOTEL EMBRACE AND THEN GO INTO A ROOM TOGETHER. HE SAT OUTSIDE IN HIS TRUCK ATE CHIPS AND WAITED. HE CALLED HER WHILE HE WAS OUTSIDE WAITING AND SHE LIED ABOUT WHERE SHE WAS. HIS WIFE NEVER SAID SHE DID THIS AND HE SAW IT WITH HIS OWN EYES. HORRIBLE!!!! He watched them leave the hotel.

HE WOULD SEE HER LEAVE IN THE MIDDLE OF THE NIGHT AFTER A PHONE CALL. SHE WOULD SAY IT WAS A COUSIN OR AUNT. HE FOUND OUT THAT WA NOT TRUE. HE CONFRONTED HIS FRIEND. FOUND OUT THE OTHER PHONE NUMBER CALLED HIS FRIEND WHEN HE HAD THE PHONE ON HIM AND ASKED HIM TO ANSWER HIS PHONE. THEN HE BEGAN TO TELL THE FRIEND ALL HE KNOW AND THAT HE DIDN'T WANT TO SEE HIM AGAIN.

Then it was Guy2 asking my now fiance questions about how we meant, ... He accused me of, or that guy of wanting to be with me. This was a a friend's Nancy's party. Then it was strange that Nancy misplaced her phone and called me on Guy2's phone.

I would always tell "T" I was not being with anyone not even interested in anyone else which was and still is true. I started to get nervous whenever I was gone too long because he and my mom would accuse me of staying at work to get away from them.

I remember him calling me when I was in bed half asleep. I answered the phone but the person had hung up. He asked me who it was I tried to look to see and say my son's name come up. I think I pressed his number and asked my son was everything ok. he said he was fine. It was not my son who called is what I later found out. I suppose I could have checked my phone more carefully. It was Tommy who called. So Tommy was angry and said I lied on purpose and that I knew it was not Greg. I swear I must have looked at the phone wrong.

There is more is anyone listening. I love this man but I got scared, nervous, I feared hurting him living this way with him always accusing me. He and my mom getting angry when I worked late. It was work.

I made the huge mistake of getting scared, then depressed, I talked to someone for a few months. I didn't want to be depressed but I wanted "T" to know I loved him. I told "T" no more at a parkign lot.
I took my clothes from "t"s home. FELT HORRIBLE BECAUSE I JUST WANTED HIM TO BELIEVE I WOULD NOT CHEAT ON HIM TRUST ME.

Then I realised he couldn't help the way he felt and I just needed to prove to him I was not cheating. Been trying to do this. CONFRONTED ONE PERSON TODAY I WILL CONFRONT OTHER PERSON T MAY THINK I'VE BEEN WITH.